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Tobacco Use DisorderNCT03551704

Smoking Cessation Treatment for Substance Use Dependents

A study testing CBT + EFT and CBT + EFT + CM in people with Tobacco Use Disorder, run by University of Oviedo at 1 site in Spain.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

The present research project aims to develop an innovative and empirically validated intervention protocol for smoking cessation among patients with substance use disorders (SUDs). For this purpose, two smoking cessation treatments tailored for SUDs will be assessed. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Tobacco Use Disorder
What is being tested?
CBT + EFT and CBT + EFT + CM
Could I receive a placebo?
No, everyone receives an active treatment
How many people
120 participants
Where
1 siteSpain
Study dates
15 Jan 2018to 30 Dec 2022
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Being aged 18 or over.
  • Having smoked 10 or more cigarettes/day within the last year.
  • Meeting the diagnostic criteria for nicotine dependence according to the Diagnostic and Statistical Manual of Mental Disorders-5th ed. (American Psychiatric Association 2013).
  • Undergoing outpatient cocaine or alcohol treatment.

Who cannot join

  • Not being able to attend the entire treatment.
  • Being currently receiving other psychological/pharmacological treatment for smoking cessation.
  • Being diagnosed with a current severe psychiatric disorder (i.e., schizophrenia,bipolar disorder).

Trial locations and contacts

1 site in 1 country.

Spain1 site
  • Clinical Unit of Addictive Behaviors

    Oviedo, Principality of Asturias, 33003

Other trials in Spain

About this study

The present research project aims to develop an innovative and empirically validated intervention protocol for smoking cessation among patients with substance use disorders (SUDs). For this purpose, two smoking cessation treatments tailored for SUDs will be assessed. Participants will be assigned to one of the following treatment conditions: 1) Cognitive-behavioral treatment for smoking cessation (CBT) + Episodic Future Thinking (EFT); 2) The same treatment alongside Contingency Management (CM) for shaping abstinence.

The main goals are:

  1. To analyze the feasibility (e.g., acceptability, compliance) of implementing the abovementioned protocol treatments to a community setting.
  2. To assess abstinence rates in each treatment condition at short and long-term follow-ups: post-treatment, one, two, three, six and twelve months after post-treatment.
  3. To assess the effects of smoking abstinence on other substance use.
  4. To analyze the moderating effect of individual variables over treatment outcomes: sociodemographic characteristics, drug demand, severity of nicotine dependence and SUD, severity of depressive symptomatology and impulsivity.
Read the detailed description

Cigarette smoking continues to have a startling adverse impact on public health, leading to more than 5 million premature deaths annually worldwide. Smoking rates are disproportionately high among the population suffering from substance use disorders (SUDs) (e.g., alcohol or cocaine). In this regard, smokers with comorbid SUD are more likely to smoke heavily and meet criteria for high nicotine dependence. As they experience more difficulty in quitting smoking than their non-SUDs counterparts, they present lower rates of abstinence.

In recent years there has been a great interest in developing effective strategies to promote abstinence in smokers with SUDs. In particular, a proliferation on CM treatments for smokers with SUDs has been recently produced. There is promising evidence for the positive effect of CM treatments upon both quitting smoking and both legal and illegal abuse drugs. On the other hand, CM has shown promising results in promoting both retention and nicotine abstinence among comorbid and non-comorbid smokers. Nevertheless, there is a lack of research exploring the effectiveness of CM on smokers with SUDs.

The primary aim of this clinical trial is to yield data on the effectiveness of CM for smoking cessation in smokers with SUDs. To address this issue, both CBT for smoking cessation plus EFT, and the same treatment alongside CM for shaping abstinence will be assessed. Participants will be randomly assigned to one of the following treatment conditions: 1) CBT+EFT; 2) CBT+EFT+ CM.

In view to assure adequate power for achieving statistical significance, investigators carried out a priori power analysis by using the G*Power 3.1. An estimated sample size of 120 participants would detect a medium effect size (Cohen's d = 0.3, with power (1-β) set at 0.97 and α = 05).

The primary analyses derived from this clinical trial will be conducted using Statistical Package for the Social Science (SPSS) version 24 for Windows. A set of descriptive and frequency analyses will be carried out with regard to participants' characteristics. Comparisons between treatment groups in both baseline characteristics and treatment outcomes will be conducted using a set of chi-square tests for categorical variables and t-tests (two-tailed) for continuous variables.

Being tested
CBT + EFT, CBT + EFT + CM
Keywords
Smoking, Substance addiction, Cocaine, Alcohol, Behavioral treatment
Medical subject headings
Tobacco Use Disorder, Smoking, Substance-Related Disorders

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • CBT + EFTBehavioural

    The CBT treatment will be implemented in 8-week group-based sessions (maximum 4 patients). Sessions will be carried out once a week over an 8-week period, with quit date occurring at fifth session. Patients will be asked to gradually reduce their nicotine intake (i.e., 25% each week). CBT components include: psychoeducation, self-monitoring, physiological feedback, training in stimulus control and strategies for controlling negative discomfort, and relapse prevention strategies.

    As part of the EFT, participants will be asked to select future smoking-related events that would occur within the following time periods: 2 weeks, 1, and 6 months. They will be instructed to generate personal audio recordings that will be used to help them think about future decision-making choices.

  • CBT + EFT + CMBehavioural

    This intervention includes the abovementioned treatment components and a CM procedure reinforcing abstinence. This arm will consist on delivering CBT and EFT and providing patients incentives to promote and reinforce abstinence contingent on abstinence. The schedule will incorporate an increasing magnitude of reinforcement.

Study groups in NCT03551704
Study groupRoleWhat they receive
CBT + EFTActive comparatorThe CBT treatment will be implemented in 8-week group-based sessions (maximum 4 patients). Sessions will be carried out once a week over an 8-week period, with quit date occurring at fifth session. Patients will be asked to gradually reduce their nicotine intake (i.e., 25% each week). CBT components include: psychoeducation, self-monitoring, physiological feedback, training in stimulus control and strategies for controlling negative discomfort, and relapse prevention strategies. As part of the EFT, participants will be asked to select future smoking-related events that would occur within the following time periods: 2 weeks, 1, and 6 months. They will be instructed to generate personal audio recordings that will be used to help them think about future decision-making choices.
Receives: Behavioral: CBT + EFT
CBT + EFT + CMExperimentalThis intervention includes the abovementioned treatment components and a CM procedure reinforcing abstinence. This arm will consist on delivering CBT and EFT and providing patients incentives to promote and reinforce abstinence contingent on biochemical verification. The schedule will incorporate an increasing magnitude of reinforcement.
Receives: Behavioral: CBT + EFT + CM

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Changes in Smoking Abstinence

    Abstinence is defined as achieving a period of at least 24 hours of abstinence (end-of-treatment) or not smoking since the prior last 7 days. Abstinence is assessed by means of carbon monoxide (CO) and cotinine samples.

    Measured: End-of-treatment (8-week), 1, 2, 3, 6 and 12 month follow-up

  2. Changes in Continuous abstinence

    Abstinence is defined as no smoking (not even a puff) since the participant´s quit day. Abstinence is assessed by means of carbon monoxide (CO) and cotinine samples.

    Measured: 1, 2, 3, 6 and 12 month follow-up since the treatment completion

Secondary outcomes (6)
  1. Changes in Other Substance Abstinence

    7-day point-prevalence. Self-reported abstinence will be confirmed by urinalyses and breath alcohol samples.

    Measured: End-of-treatment (8-week), 1, 2, 3, 6 and 12 month follow-up since the treatment completion

  2. Changes in Drug demand

    Alcohol and tobacco demand will be assessed by using the Alcohol and Tobacco Purchase Task. These tasks allow to capture changes in the relative reinforcing efficacy of different drugs through the course of treatment. From this tasks, five demand indices are derived. Specifically, we will compute the indices that follow:

    Breakpoint: The first price at which consumption is zero

    Omax: maximum expenditure for cigarettes

    Pmax: price at which expenditure is maximized

    Intensity: consumption at the lowest price

    Elasticity: sensitivity of cigarette consumption to increases in costs

    Measured: Intake (baseline), end-of-treatment (8-week),1,2,3,6 and 12 months follow-up since treatment completion

  3. Changes in Health-Related Quality of Life

    This variable will be assessed by using the EuroQol-5D (EQ-5D). It essentially consists of 2 pages: the EQ-5D descriptive system and the EQ visual analogue scale (EQ VAS). The EQ-5D descriptive system comprises the following five dimensions: mobility, self-care, usual activities, pain/discomfort and anxiety/depression. Each dimension has 3 levels: no problems, some problems, and extreme problems. The patient is asked to indicate his/her health state by ticking the box next to the most appropriate statement in each of the five dimensions.

    Measured: Intake (baseline), end-of-treatment (8-week),1,2,3,6 and 12 months follow-up since treatment completion

  4. Changes in Depression

    Depression will be assessed using the Beck's Depression Inventory- Second Edition (BDI-II). Scores are examined as a continuous scale. None/minimal depression is defined as scoring below the clinical screening BDI cutoff of mild depression (<14). Depression diagnosis is assessed in those individuals scoring 14 or more on the BDI-II by means of the Structured Clinical Interview for the Diagnostic and Statistical Manual for Mental Disorders-Clinical Version (SCID-I/CV).

    Measured: Intake (baseline), end-of-treatment (8-week),1,2,3,6 and 12 months follow-up since treatment completion

  5. Changes in Impulsivity

    Impulsivity levels will be assessed by means of the delay discounting task. Participants will complete a computerized version of this task and will be presented with several choices. An adjusting-amount procedure will be used (Holt, Green, \& Myerson, 2012). The delay values used are one day, one week, one month, six months, one year, five years, and 25 years. Delay discounting is calculated using logk and the area under the curve (AUC).

    Measured: Intake (baseline), end-of-treatment (8-week),1,2,3,6 and 12 months follow-up since treatment completion

  6. Cost Analysis

    The Drug Abuse Treatment Cost Analysis Program (DATCAP) is a cost data collection instrument and interview guide designed to be used in a variety of medical treatment and social service settings.

    The instrument is intended to collect and organize detailed information on resources used in service delivery and their associated dollar cost. Resource categories include personnel, supplies and materials, contracted services, buildings and facilities, equipment, and miscellaneous items.

    The Drug Abuse Treatment Cost Analysis Program (DATCAP) is a cost data collection instrument and interview guide designed to be used in a variety of medical treatment and social service settings.

    Measured: End of the project when all participant´s data are collected. Data expected: three years after the study onset.

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted11 Jun 2018
  2. Study start15 Jan 2018
  3. Primary completion30 Nov 2022
  4. Study completion30 Dec 2022

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Model description
Participants are randomly assigned to each of the two treatment conditions in accordance with a computer-generated randomization list. The treatment conditions will be actively running in parallel.
Masking
None (open label)
Enrolment
120 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03551704
Sponsor's protocol ID
MSSSI-2017-2017I036
Status last verified
Apr 2024
First submitted
9 May 2018
Last updated
15 Apr 2024
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Secades-Villa R, Gonzalez-Roz A, Garcia-Perez A, Becona E. Psychological, pharmacological, and combined smoking cessation interventions for smokers with current depression: A systematic review and meta-analysis. PLoS One. 2017 Dec 5;12(12):e0188849. doi: 10.1371/journal.pone.0188849. eCollection 2017.

    PubMed 29206852
  • McKelvey K, Thrul J, Ramo D. Impact of quitting smoking and smoking cessation treatment on substance use outcomes: An updated and narrative review. Addict Behav. 2017 Feb;65:161-170. doi: 10.1016/j.addbeh.2016.10.012. Epub 2016 Oct 27.

    PubMed 27816663
  • Secades-Villa R, Vallejo-Seco G, Garcia-Rodriguez O, Lopez-Nunez C, Weidberg S, Gonzalez-Roz A. Contingency management for cigarette smokers with depressive symptoms. Exp Clin Psychopharmacol. 2015 Oct;23(5):351-60. doi: 10.1037/pha0000044. Epub 2015 Aug 17.

    PubMed 26280589
  • Weidberg S, Vallejo-Seco G, Gonzalez-Roz A, Garcia-Perez A, Secades-Villa R. In-treatment cigarette demand among treatment-seeking smokers with depressive symptoms. Addict Behav. 2018 Jul;82:35-43. doi: 10.1016/j.addbeh.2018.02.022. Epub 2018 Feb 16.

    PubMed 29482033
  • Cooney JL, Cooper S, Grant C, Sevarino K, Krishnan-Sarin S, Gutierrez IA, Cooney NL. A Randomized Trial of Contingency Management for Smoking Cessation During Intensive Outpatient Alcohol Treatment. J Subst Abuse Treat. 2017 Jan;72:89-96. doi: 10.1016/j.jsat.2016.07.002. Epub 2016 Jul 15.

    PubMed 27542442

Questions about this trial

What is this clinical trial studying?

A study testing CBT + EFT and CBT + EFT + CM in people with Tobacco Use Disorder, run by University of Oviedo at 1 site in Spain.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 4 inclusion and 3 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 15 Apr 2024. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Spain. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Changes in Smoking Abstinence (time frame: End-of-treatment (8-week), 1, 2, 3, 6 and 12 month follow-up). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT03551704, which also lists 5 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 15 Apr 2024.

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